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Published online before print March 29, 2006, 10.1183/09031936.06.00110205
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Eur Respir J 2006; 28:31-34
Copyright ©ERS Journals Ltd 2006

Use of a T-cell-based test for detection of tuberculosis infection among immunocompromised patients

F. Piana1,2, L. R. Codecasa2, P. Cavallerio1, M. Ferrarese2, G. B. Migliori3, L. Barbarano4, E. Morra4 and D. M. Cirillo1

1 Emerging Bacterial Pathogens Unit, San Raffaele Scientific Institute for Research and Clinical Care, 2 Villa Marelli Institute, Niguarda Ca’ Granda Hospital, 4 Niguarda Ca’ Granda Hospital, Milan, and 3 WHO Collaborating Centre for Tuberculosis and Lung Disease, S. Maugeri Foundation, Scientific Institute for Research and Clinical Care, Tradate, Italy.

CORRESPONDENCE: D. M. Cirillo, Emerging Bacterial Pathogens Unit, San Raffaele-Turro, Via Stamira D’Ancona 20, 20127 Milan, Italy, Fax: 39 0226437989. E-mail: cirillo.daniela{at}hsr.it

Keywords: Contact tracing, haematology, interferon-{gamma}, T-SPOT.TBTM, tuberculosis

Received: September 21, 2005
Accepted February 27, 2006

The aim of this study was to compare the performance of the T-SPOT.TBTM test, a T-cell-based test, with the tuberculin skin test (TST) in the diagnosis of latent tuberculosis (TB) infection.

The study was carried out in 138 immunosuppressed haematology patients who had been nosocomially exposed to a case of smear-positive TB.

Overall, 44.2% of the contacts were positive by T-SPOT.TBTM test, and 17.4% by TST (concordance 67.8%). The apparent prevalence of infection fell from 25.9 to 14.5% with the TST with increasing immunosuppression, although this difference was not significant. In contrast, the apparent prevalence of infection with the T-SPOT.TBTM test was unaffected at 44.6 and 44.3%, respectively. The T-SPOT.TBTM test had an overall indeterminate rate of 4.3%, and this was also unaffected by the level of immunosuppression.

This study suggests that the T-SPOT.TBTM test maintains its sensitivity and performance in immunocompromised patients, identifying a large number of truly infected patients anergic to the tuberculin skin test.




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